| NPI | 1760093298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IA C177438) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 53-81038-122) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2022010794) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP022159) | |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2024-05-23 |